Provider Demographics
NPI:1184989477
Name:MEINTS, JASON (DPT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:MEINTS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9109 BLONDO ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-6100
Mailing Address - Country:US
Mailing Address - Phone:515-612-5390
Mailing Address - Fax:402-778-9739
Practice Address - Street 1:9109 BLONDO ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-6100
Practice Address - Country:US
Practice Address - Phone:515-612-5390
Practice Address - Fax:402-778-9739
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE3235OtherNE LICENSE
IAI19172062Medicare PIN
NE099668011Medicare PIN
NE099668Medicare PIN
IAI19172Medicare PIN